Sample Petition for Single Proposition to Create and Fund a School District Public Library

Requires 25 signatures

I, the undersigned, do hereby state that I am a duly qualified voter of the XXXXXX Central School District, that I was registered to vote therein at the time of the last preceding general election, that my present place of residence and my place of residence at the time of the last preceding general election are truly stated opposite my signature hereto, I intend to support at the ensuing district meeting, and I do hereby petition the Board of Education of the XXXXXX Central School District to place on the ballot, the following question to be voted on at the next district meeting to be held on the xxx day of May, 2005 or at a special meeting to be scheduled for this purpose no later than July 1, 2005:

QUESTION: Shall the XXXXXX Public Library be permanently established as a school district library for the benefit and free use, of all residents of the XXXXXX Central School District, such library to have seven Library Board Trustees, whose members are elected by the voters of the School District for terms of up to five years, and be authorized to raise $XXXXXXX, separate and apart from the annual School District budget, to support and maintain such library, said appropriation shall be raised annually by a tax upon the taxable property of said School District and shall be an annual appropriation thereafter until changed by further vote of the majority of electors of the XXXXXX Central School District, and shall be levied and collected yearly as are other general taxes?

In witness whereof, I have hereunto set my hand, the day and year placed opposite my signature

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Date

Name (print)

Signature

Address

Election District

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2

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3

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4

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5

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Continue table to accommodate a minimum of 25 signatures

STATEMENT OF WITNESS

I, _________ (Name of witness) state: I am a duly qualified voter in the State of New York and now reside in the (City, Town or Village) of ___________ in New York State, at ________________________________(Address) therein. I was last registered for the general election in the year ____ from __________________, the County of ___________ in New York State. The said residence was then in the _______ (Election District) in the __________________(Town in outside the City). I know each of the voters whose names are subscribed to this petition sheet containing ________ signatures, and each of them subscribed the same in my presence and upon so subscribing declared to me that the forgoing statement, made and subscribed by him, was true.